Forms

If the patient is an adult, go to the “All Adults” section and complete the listed forms, or if the patient is a child or adolescent, complete the forms under “All Children/Adolescents.” Other forms may or may not be applicable; we can discuss that at the first session. If you do not yet have Adobe Acrobat Reader installed on your computer to open PDFs, you can download it for free from Adobe here.

Some of these forms are "fillable" PDFs that can be filled out on your computer. Completed forms can be uploaded from your computer at our Contact page or attached to an email sent to Office Manager Barbara Griffin at bgnorthpointpsychology@yahoo.com. Forms can also be printed and faxed to (678) 624-0258. If you plan to bring completed forms with you to the first session, PLEASE PRINT TWO-SIDED if possible.

All Adults:

Adult Intake Form

Adult_Intake_Form.pdf
File Size:	318 kb
File Type:	pdf

Download File

Psychological Services Contract

npp_psycholgical_services_contract.pdf
File Size:	273 kb
File Type:	pdf

Download File

HIPAA

HIPAA.pdf
File Size:	277 kb
File Type:	pdf

Download File

All Children/Adolescents:

Child/Adolescent Intake Form

npp_child_adolescent_intake_form_102519a.pdf
File Size:	253 kb
File Type:	pdf

Download File

Psychological Services Contract

psycholgical_services_contract.pdf
File Size:	262 kb
File Type:	pdf

Download File

HIPAA

hipaa.pdf
File Size:	277 kb
File Type:	pdf

Download File

If the child or adolescent is here for testing, also complete the following:

Developmental and Medical History

Developmental_and_Medical_History.pdf
File Size:	1046 kb
File Type:	pdf

Download File

Authorization of Release of Information Forms:
A separate Release Form is required for each person or facility sending/receiving information to/from us.
Please be sure to sign each Release Form in two places.

Adult Release Form

npp_adult_release_form_121119a.pdf
File Size:	616 kb
File Type:	pdf

Download File

Child/Adolescent Release Form

npp_child_adolescent_release_form_121119a.pdf
File Size:	172 kb
File Type:	pdf

Download File

Informed Consent for Forensic Services:

Custody Evaluation

npp_informed_consent_for_psychological_custody_evaluation.pdf
File Size:	253 kb
File Type:	pdf

Download File

Psychological Evaluation During a Legal Dispute

npp_informed_consent_for_psychological_evaluation_during_a_legal_dispute.pdf
File Size:	252 kb
File Type:	pdf

Download File

Forensic Psychological Evaluation

npp_informed_consent_for_forensic_psychological_evaluation.pdf
File Size:	250 kb
File Type:	pdf

Download File

Collateral Agreement

collateral_agreement.pdf
File Size:	180 kb
File Type:	pdf

Download File